限制性输液对晚期肝癌并发症及患者生存质量的影响

Effect of restrictive intravenous fluid on the complications and quality of life in the advanced hepatocellular carcinoma patients

目的探讨限制性输液对晚期肝癌并发症及患者生存质量的影响。方法回顾性分析川北医学院附属医院2010年3月至2016年3月共357例晚期肝细胞癌患者，根据液体管理方案分为限制性输液组128例和对照组（常规开放性输液组）229例；对比两组患者日均输液量、血浆白蛋白浓度、胸腹腔积液发生率、静脉炎发生率、呕吐发生率、褥疮及坠积性肺炎发生率、癌痛程度和焦虑程度。结果限制性输液组日均输液量[（720．29±106．84）m1]明显少于对照组[（1820．36±342．12）ml]（P〈0．05）；限制性输液组血浆白蛋白浓度[（35．65±2．21）g/L]明显高于对照组[（32．25±2．32）g／L]（P〈0．05）；限制性输液组胸腹腔积液、坠积性肺炎、静脉炎、呕吐、褥疮的发生率分别为6．25％、11．72％、4．69％、8．59％、3．91％，均低于对照组的13．97％、24．45％、10．92％、17．47％、10．04％，差异有统计学意义（均P〈0．05）；限制性输液组患者癌痛评分及焦虑评分分别为（5．21±1．09）分、（39．12±5．54）分，与对照组的（5．68±1．18）分、（41．56±6．78）分比较，差异有统计学意义（均P〈0．01）。结论限制性输液有助于降低晚期肝细胞癌相关并发症，能有效改善肿瘤患者生存质量。

Objective To investigate the effect of restrictive intravenous fluid on the complications and quality of life in the advanced hepatocellular carcinoma patients. Methods Clinical data of Three hundred and fifty-seven cases with advanced hepatocellular carcinoma from Mar 2010 to Mar 2016 was retrospectively analyzed. One hundred and sixty-eight cases were recruited in the restrictive intravenous fluid （RIF） group, and One hundred and eighty-nine cases were involved in the control group. The average volume of intravenous fluid of each day, plasma albumin concentration, splanchnocoel hydrops rate, phlebitis, incidence of vomiting, cancer related pain degree, anxiety degree were compared in the two groups. Results The average volume of intravenous fluid of each day in the RIF group [ （720. 29 ±106. 84 ） ml ] were much lower than that in the control group [ （1 820. 36 ±342. 12 ）ml ] （P 〈 0. 05 ）. The plasma albumin concentration in the RIF group [ （35.65 ±2. 21 ）g/L] were higher than that in the control group [ （32. 25±2. 32） g/L] （P 〈 0. 05）. The rate of splanchnocoel hydrops, phlebitis, vomiting, bedsores, and hypostatic pneumonia in RIF group were 6. 25% , 4. 69% , 8.59% , 3.9% , 11.72% and those in the control group were 13.97% , 10. 92% , 17.47% , 10. 04% , and 24. 45% , respectively （ P 〈 0. 05 ）. Moreover, the scores of cancer related pain and anxiety were much lower in the RIF group （5.21 ±1.09, 39. 12 ±5.54） than those in the control group（5.68±1.18, 41.56 ± 6. 78） （P 〈 0. 01 ）. Conclusions Restrictive intravenous fluid therapy can decrease the cancer associated complications and improved the quality of life in the advanced hepatocellular carcinoma patients.